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Cardiovascular Research Journal - Volume:10 Issue: 4, Dec 2016

International Cardiovascular Research Journal
Volume:10 Issue: 4, Dec 2016

  • تاریخ انتشار: 1395/10/10
  • تعداد عناوین: 10
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  • Samad Ghaffari, Naser Aslanabadi, Babak Kazemi, Morteza Ghojazadeh, Saber Azamiaghdash, Mohammad Naghavi-Behzad, Reza Piri *, Ali Naghavi-Behzad* Pages 151-158
    Context: Coronary artery diseases are mostly detected using angiographic methods demonstrating arteries status. Nevertheless, Myocardial Infarction (MI) may occur in the presence of angiographically normal coronary arteries. Therefore, this study aimed to investigate the prevalence of MI with normal angiography and its possible etiologies in a systematic review.
    Evidence Acquisition: In this meta-analysis, the required data were collected from PubMed, Science Direct, Google Scholar, Scopus, Magiran, Scientific Information Database, and Medlib databases using the following keywords: “coronary angiograph”, “normal coronary arteries”, “near-normal coronary arteries”, “heart diseases”, “coronary artery disease”, “coronary disease”, “cardiac troponin I”, “Myocardial infarction”, “risk factor”, “prevalence”, “outcome”, and their Persian equivalents. Then, Comprehensive Meta-Analysis software, version 2 using randomized model was employed to determine the prevalence of each complication and perform the meta-analysis. P values less than 0.05 were considered to be statistically significant.
    Results
    Totally, 20 studies including 139957 patients were entered into the analysis. The patients’ mean age was 47.62 ± 6.63 years and 64.4% of the patients were male. The prevalence of MI with normal or near-normal coronary arteries was 3.5% (CI = 95%, min = 2.2%, and max = 5.7%). Additionally, smoking and family history of cardiovascular diseases were the most important risk factors. The results showed no significant difference between MIs with normal angiography and 1- or 2-vessel involvement regarding the frequency of major adverse cardiac events (5.4% vs. 7.3%, P = 0.32). However, a significant difference was found between the patients with normal angiography and those with 3-vessel involvement in this regard (5.4% vs. 20.2%, P
    Conclusions
    Although angiographic studies are required to assess the underlying etiology of MI, physicians facing patients presenting with the clinical features of MI in presence of normal or near-normal coronary arteries should consider the prevalence and risk factors of MI with normal or near-normal coronary arteries.
    Keywords: Myocardial Infarction, Angiography, Prevalence, Risk Factor
  • Oktavia Rahayu Adianingsih, Fredo Tamara, Ardina Pramesti Putri, Angi Nurkhairina, Thoha Muhajir Albaar, Maimun Zulhaidah Arthamin, Valentina Yurina * Pages 159-164
    Background
    Atherosclerosis is the main cause of cardiovascular disease, which has no effective preventive treatments. Lectin-like Oxidized LDL Receptor-1 (LOX-1) is a major receptor of ox-LDL in endothelial cells and plays an important role in atherosclerosis.
    Objectives
    This research aimed to determine the role of LOX-1 protein vaccination in inhibiting atherosclerosis plaque progression through measurement of foam cells number and aorta wall thickness and reducing inflammation through Nuclear Factor– kappa B (NF-κB) activation and endothelial Nitric Oxide Synthase (eNOS) expression.
    Materials And Methods
    This experimental study was conducted on seven groups of 28 male Wistar rats aged 6 to 8 weeks, including negative control group (normal diet rats), positive control group (atherogenic diet rats without vaccination), and 4 other experimental groups receiving atherogenic diet and LOX-1 vaccine containing 1, 10, 100, and 1000 ng LOX-1. Vaccination was performed on days 0, 21, and 35. The vaccines were also supplemented by aluminum hydroxide (alum) as an adjuvant. Finally, the 7th group only received atherogenic diet and alum. On the 57th day, the rats were euthanatized and their serum anti-LOX-1 IgG level, NF-κB activation, eNOS expressions, foam cells number, and aorta wall’s thickness were measured. After all, the data were analyzed using the SPSS statistical software, version 20 and P
    Results
    The results indicated that the vaccine was unable to raise the anti-LOX-1 IgG level significantly (P = 0.010). However, it was able to inhibit foam cells formation and aorta wall’s thickness significantly (P = 0.001). Furthermore, LOX-1 vaccination could significantly inhibit the activation of NF-κB (P = 0.001) and increase eNOS expression (P = 0.001).
    Conclusions
    LOX-1 vaccine could potentially inhibit atherosclerosis by decreasing NF-κB activation, increasing eNOS expression, and inhibiting atherosclerosis plaques progression. Although the vaccine did not induce humoral immune response, it successfully inhibited the progression of atherosclerosis. Thus, it was predicted to work through other mechanisms, such as inducing cellular immune response.
    Keywords: Atherosclerosis, Inflammation, Vaccination
  • Masoud Mozafari, Ali Akbar Nekooeian*, Mohammad Reza Panjeshahin Pages 165-171
    Background
    Resveratrol has beneficial effects on experimental and clinical hypertension and diabetes.
    Objectives
    This study aimed at examining antidiuretic and antihyperlipidemic effects of resveratrol in rats with simultaneous type II diabetes and endovascular hypertension.
    Materials And Methods
    This study was performed on eight groups of male SpargueDawley rats each containing 8 - 10 animals as follows: control, diabetic (induced by streptozotocin and nicotinamide), renovascular hypertensive (induced by placing Plexiglas clips on the left renal arteries), sham, simultaneously hypertensive–diabetic receiving vehicle (distilled water), and 3 simultaneously hypertensive-diabetic groups receiving 5, 10, and 20 mg/kg/day resveratrol. Blood pressure and heart rate were measured weekly and fasting blood glucose, serum cholesterol, triglyceride, and markers of oxidative stress were measured after 4 weeks of treatment with resveratrol vehicle. The data were analyzed using one-way Analysis of Variance (ANOVA) and Duncan’s multiple range tests. Data analysis was done using SigmaStat software and P ≤ 0.05 was considered to be statistically significant.
    Results
    Serum malondialdehyde, systolic blood pressure, heart rate, fasting blood glucose, blood glycated hemoglobin, and serum triglyceride, total cholesterol, and low-density lipoprotein cholesterol levels were significantly higher in the hypertensivediabetic group receiving vehicle compared to the control group (P
    Conclusions
    The findings indicated that resveratrol had antidiabetic, antihypertensive, and antihyperlipidemic effects, which might be partly due to an antioxidant mechanism.
    Keywords: Resveratrol, Diabetes, Renovascular Hypertension, Oxidative Stress, Rat
  • Fatma Demet Ince *, Aysenur Atay, Mehmet Hicri Koseoglu, Hamit Yasar Ellidag, Murat Yesil, Erdal Deveci Pages 172-178
    Background
    Some mutations of Methylenetetrahydrofolate Reductase (MTHFR) gene cause a decrease in MTHFR activity. Decreased MTHFR activity may, in turn, be associated with increased plasma homocysteine level and vascular disease.
    Objectives
    This study aimed to assess the effect of homocysteine, MTHFR C677T, and A1298C gene polymorphisms on the extent and severity of Coronary Artery Disease (CAD).
    Patients and
    Methods
    This study was conducted on 53 patients with the diagnosis of myocardial infarction. According to the results of coronary angiography, Reardon coronary artery scoring was applied to assess the extent and severity of atherosclerosis. MTHFR C677T and A1298C gene mutations and serum homocysteine, folate, and vitamin B12 levels were analyzed, as well.
    Results
    TT genotype of MTHFR C677T gene polymorphism was not found in any of the patients. On the other hand, the incidence of CC and CT genotypes in MTHFR C677T gene polymorphism was 47.2% and 52.8%, respectively. Besides, the incidence of AA, AC, and CC genotypes in MTHFR A1298C gene polymorphism was 37.7%, 45.3%, and 17%, respectively. The results showed no significant difference among different MTHFR genotypes regarding the extent and severity of CAD. Additionally, serum homocysteine, folate, and vitamin B12 levels were not associated with the extent and severity of CAD.
    Conclusions
    Although most studies have found a relationship between homocysteine and MTHFR C677T and A1298C gene polymorphism, this relationship was not observed in our study. According to the results, the severity of CAD was not affected by homocysteine level or MTHFR genotypes. Thus, investigation of different MTHFR gene polymorphisms in a larger number of participants would help understand the genetic basic of CAD.
    Keywords: Coronary Artery Disease, Homocysteine, Methylenetetrahydrofolate Reductase, Polymorphism
  • Mahin Dianat, Samira Saadatfard, Mohammad Badavi, Akram Ahangar Pour, Najmeh Sadeghi * Pages 179-184
    Background
    Cardiomyopathy is one of the major complications of cirrhosis. Free radical scavenging and antioxidant substances can reduce cardiomyopathy and cardiovascular mortality of cirrhosis. Caffeic Acid Phenethyl Ester (CAPE) is one of the major compounds of polyphenols with anti-inflammatory and free-radical scavenging activities.
    Objectives
    The present study aimed to identify the association between mitochondrial mutations in tRNAGlu and Cytb genes and CHD in Iranian patients.
    Materials And Methods
    In this study, thirty male Sprague-Dawley rats (200 - 250 g) were divided into three groups (sham, cirrhotic, and cirrhotic treated with CAPE). CAPE was administrated (1 μg/kg/day, ip) for 5 weeks. Bile Duct Ligation (BDL) was applied in order to induce cirrhosis. Five weeks after surgery, left ventricular function was evaluated by Langendorff system, and data of the sham group were considered as ventricular function before the BDL surgery. For histopathological evaluation also, livers of all the rats were removed and processed for light microscopy. Then, all the serum biochemical parameters were measured. After all, the data were entered into the SPSS statistical software, version 18 and were analyzed using one-way ANOVA followed by LSD test. The data were presented as mean ± SEM and P
    Results
    The maximum rate of increase and decrease in ventricular pressure (± dp.dt-1), which was reduced by cirrhosis (P
    Conclusions
    The findings indicated that CAPE improved the left ventricular function in cirrhotic rats. Thus, it may be considered to be a new therapeutic approach in future cirrhotic cardiomyopathy.
    Keywords: Caffeic Acid Phenethyl Ester, Left Ventricular Function, Cardiomyopathy
  • Hasan Mahfood *, Houssam Balleh Pages 185-192
    Background
    Strain Rate Imaging (SRI) is a new diagnostic technique.
    Objectives
    The present study aimed to determine the diagnostic value of SRI in detection and localization of coronary lesions in patients with chest pain, but without apparent wall motion abnormalities.
    Patients and
    Methods
    This study was conducted on 91 patients with suspicion of stable angina or unstable angina selected through simple random sampling. SRI was done using Tissue Doppler Imaging (TDI) prior to coronary angiography. All the patients had normal electrocardiograms and normal wall motion in echocardiography. Longitudinal strain was obtained for 18 segments in the Left Ventricle (LV). Then, peak longitudinal systolic strain (εsys), post systolic shortening, and its characteristics were assessed in normal and abnormal segments. Significant coronary lesion was considered if stenosis was above 70%.
    Results
    The results showed that 40 patients with heterogeneous strains and 2 patients with constant strains had significant coronary stenosis. Besides, 31 patients with constant strains and 18 ones with heterogeneous strains had normal or minimal coronary lesions. Moreover, εsys was lower in ischemic than in normal segments (P
    Conclusions
    SRI is a new non-invasive diagnostic tool that could be used for detecting coronary stenosis in patients with chest pain, but without apparent wall motion abnormalities on echocardiography.
    Keywords: Echocardiography, Elasticity Imaging Techniques, Coronary Artery Disease
  • Mehri Khatami *, Mohammad Mehdi Heidari, Nafiseh Karimian, Mehdi Hadadzadeh Pages 193-198
    Background
    Distribution of mitochondrial oxidative energy metabolism is a characteristic of cardiomyocyte dysfunction and congenital familial and sporadic heart diseases. Several studies have indicated that mutations in mitochondrial DNA, particularly in tRNAs and MT-CYB coding for cytochrome B in complex III (CIII), were associated with cardiologic disorders. We hypothesized that mutations in these positions might play an important causal or modifying role in congenital heart defects. Congenital Heart Diseases (CHDs) are the most common anomaly in newborns and the leading non-infectious cause of mortality in the first year of life. These defects are multifactorial complex diseases resulting from both genetic predisposition and environmental risk factors. Despite advances in molecular medicine, the genetic mechanism underlying mitochondrial genetic determinants of development of CHD has remained poorly understood.
    Objectives
    The present study aimed to identify the association between mitochondrial mutations in tRNAGlu and Cytb genes and CHD in Iranian patients.
    Materials And Methods
    In this case-control study, tRNAGlu and MT-CYB genes were analyzed in DNA isolated from peripheral blood of 84 Iranian pediatric patients with non-familial CHD and 72 controls for alterations. The cases and healthy controls were matched regarding age and gender.
    Results
    A total of three nucleotide variations were detected by Polymerase Chain Reaction-Single-Strand Conformation Polymorphism (PCR-SSCP) and sequencing. One of them was located in tRNAGlu (A14696T) found in a child with tetralogy of fallot and ventricular septal defect, which was assessed as a pathogen mutation. The second mutation was a homoplasmic variant (m.14766C > T) in cytb gene and was not detected in the healthy controls.This variant altered an amino acid (T7I) with moderately interspecific amino acid conservation indicative of the functional importance of the residue. Finally, a homoplasmic synonymous variation (T14783C) was observed in 70.4% of the CHD patients.
    Conclusions
    The results suggested that mitochondrial mutations might be associated with CHD in Iranian pediatric patients. Thus, more patients with CHD should be examined for mutations in mtDNA in order to clarify the role of variants.
    Keywords: Congenital Heart Disease, tRNAGlu
  • Konstantinos Giakoumidakis * Pages 199-201
    Acute Hypoxemic Respiratory Failure (AHRF) during mechanical ventilation on high fraction of inspired oxygen is an unusual manifestation of respiratory insufficiency after an elective cardiac surgical procedure. A 68-year old man who had developed AHRF during his mechanical ventilatory support after an elective Bentall procedure was reported. Increased duration of cardiopulmonary bypass in conjunction with his hemodynamic instability and tissue hypo-perfusion during the early postoperative period were the main reasons for the acute respiratory failure onset accompanied by severe hypoxemia. A slow oxygenation improvement was observed after the implementation of specific interventions for arterial pressure and heart rhythm stabilization. Considering the patient’s clear chest x-ray findings, it was supposed that he had progressed to type IV respiratory failure. Hemodynamic stabilization and improvement of tissue perfusion could treat the underlying cause of the patient’s acute respiratory failure.
    Keywords: Aorta, Cardiovascular Surgical Procedures, Case Report, Respiratory Insufficiency
  • Mehrdad Rezaei, Amirmasoud Borghei, Nazanin Farahbakhsh, Hamid Amoozgar * Pages 202-204
    Scimitar syndrome is a rare and complex congenital defect that often involves hypoplasia of the right lung, partial anomalous pulmonary venous connection of the right lung draining into the inferior vena cava, and a systemic collateral artery from the descending aorta supplying the right lower lobe (lobar sequestration). Our case was a male newborn with scimitar syndrome associated with an absent right pulmonary artery, imperforated anus, and coarctation of the aorta. Hemodinamically, the patient was asymptomatic and diagnosed accidentally. This combination has not been reported before. The pathological process of the scimitar syndrome is unclear. However, it appears to originate from a basic developmental disorder of the complete pulmonary bud early in embryogenesis. This rare syndrome with different presentations can occur alone or in combination with cardiac and /or non-cardiac anomalies.
    Keywords: Aortic Coarctation, Scimitar Syndrome, Imperforate Anus, Neonate, Pulmonary Artery, Abnormalities
  • Alberto Cresti *, Giovanni Donato Aquaro, Alberto Picotti, Gonenc Kocabay, Giancarlo Todiere Pages 205-208
    Isolated Papillary Muscle (PM) hypertrophy has been supposed to be a phenotypic variant of hypertrophic cardiomyopathy. Whether this finding may explain an electrocardiographic pattern of left ventricular hypertrophy has to be demonstrated. A cardiac magnetic resonance imaging may add additional crucial information. Our case was a 26-year-old asymptomatic male cyclist who underwent routine sport medicine screening. His cousin had suddenly died during a bicycle race at 40 years of age, and autopsy had revealed a hypertrophic cardiomyopathy. Screening revealed an electrocardiographic pattern of left ventricular hypertrophy. A multimodal imaging examination was also performed and the only abnormal finding was a hypertrophic anterolateral PM and cardiac magnetic resonance imaging showed fibrotic substitution of its head. An otherwise unexplained electrocardiographic pattern of left ventricular hypertrophy can be justified by an isolated PM hypertrophy. Cardiac magnetic resonance imaging is crucial for precise ventricular wall and papillary thickness measurement. In the presence of an isolated PM hypertrophy, postgadolinium T1 mapping can demonstrate the presence of abnormal tissue and probably fibrosis of the papillary head, which can confirm the presence of a strictly localized form of hypertrophic cardiomyopathy.
    Keywords: Hypertrophic Cardiomyopathy, Papillary Muscles